Thursday, April 28, 2011

Eating a Vegetarian Diet. Not As Healthy As You May Believe.

You hear vegetarian and what comes to mind? A nutritious, disease preventing, high fiber diet? Wholesome meals full of whole grains, nuts and seeds, fruits and vegetables, chock full of vitamins and minerals? Slim and fit individuals living a healthy lifestyle, carefully meeting their nutritional needs?

If only it were so! Perhaps in its ideal form this diet is filled with all the protein, healthy fats and unprocessed carbohydrate you might need to stay healthy. It also provides a full range of antioxidants, including flavonoids, found in color-rich fruits and vegetables, as well as in nuts. These compounds are linked with prevention of many cancers, heart disease and aging related conditions. And if you include three low fat dairy servings per day, the model vegetarian diet satisfies the DASH diet for hypertension. This fruit and vegetable filled diet, together with the mineral-rich low fat dairy has been shown in studies to significantly improve blood pressure as effectively as medication.

But in practice, that’s just not how it is. Twenty-five years of counseling clients has shown me how real people live as vegetarians. And it’s not pretty. Here’s a look at what really happens to many vegetarians. Check out these pitfalls to healthy vegetarianism to be sure to avoid.

Vegetarians may set too many unnecessary rules.

Instead of eating the healthy diet described above, they may limit their fats, failing to meet their needs for essential fatty acids. Reduced fat soy milk or lower fat avocado—are they really necessary? Why choose such items?
Being fat phobic, they may omit valuable food sources such as nuts and nut butters, such as peanut butter and almond butter, eggs and even avocado. As a result of this extra layer of rules, it may be challenging to maintain their weight in a healthy range. With their limited selection, they also exclude valuable sources of protein-rich foods.
These vegetarians typically are not yet diagnosable as eating disordered. For them, vegetarianism is simply another way to limit their intake in a socially acceptable way. Vegetarianism is healthy, right?

They have no interest in exploring unfamiliar vegetarian food choices.

And so they limit their intake to vegetarian meals such as pasta, grilled cheese, and pizza, for instance. Now don’t get me wrong. There’s no problem with including these foods, as part of a balanced diet. But vegetarian choices tend to be limited, particularly when eating out. And if you don’t include much variety, the calorie density of your diet can become quite high. This becomes more exaggerated when you don’t care for many fruits and vegetables. And so your entrĂ©e portion needs to be larger to feel satisfied. Typically, these individuals end up gaining weight unexpectedly, in spite of their good intentions to eat a “healthy” vegetarian diet. As a result, they are left with a less than balanced diet and are struggling with their weight.

They are cooking challenged or have little time for food preparation.

As a result, they rely on mostly processed foods, generally quite high in sodium. Take a look at the labels on the canned beans or refried beans. Explore the sodium levels of the many soy-based and Quorn brand processed vegetarian products. To achieve the equivalent of three ounces of animal protein (a deck of cards size), you’d consume approximately 1200 mgs of sodium, from this single protein alternative, in a reasonable portion. If you are choosing vegetarianism for the prevention of heart disease, you may want to rethink this choice. If you have high blood pressure, the current recommendation is for a total of 1500 mgs. per day! You’d be better off allowing for lean protein sources such as white meat poultry, or fish, for the pescetarians.

If your nutrient needs are high (if you are still growing, quite active, very tall, pregnant or nursing, or underweight), vegetarianism can be challenging.  

A healthy vegetarian diet, high in whole grains, fruits, vegetables and legumes is high volume, high fiber with low caloric-density. As a result, it can be very filling. If you are someone with a high calorie requirement (like those described above), it takes more effort to meet your needs, while still feeling physically comfortable. It is certainly achievable, but requires a higher intake of fats and a bit more planning. Otherwise, you’ll frequently feel full and have a difficult time consuming all that your body requires.

Oh no! My daughter has decided to become a vegetarian!

Mrs. Katz called me earlier this week, seemingly alarmed, given the tone of her voice on the phone. She just discovered that her daughter has been limiting her eating to vegetarian choices for the past 3 weeks. Rebecca was well known to me from more than a year of regular visits for her eating disorder. Last time I saw her, 6 weeks ago, she had been doing great. She had been maintaining her weight in a health range, without symptoms, and appeared quite relaxed and comfortable about the changes she had made. She was allowing herself a full range of foods, including items formally considered junk foods. And she achieved all this while competing on her high school swim team. For many, many, months now, I could say she had fully recovered.

Mrs. Katz had good reason to contact me. News of her daughter’s becoming vegetarian needed to be explored, to ensure it was not a slip into more eating disordered thinking and behavior.

When I met with Rebecca today, here’s what I concluded. That Mrs. Katz has no need for concern. That while a vegetarian diet could red flag unnecessary dietary restriction, for Rebecca I felt assured that limiting her intake was not the goal (or likely to result from her new found vegetarian identity). Yes, she would have to be mindful to maximize her iron intake, as well as her protein, calcium and Vitamin D, nutrients which often fall short when eating vegetarian. Not being a vegan, B12 deficiency was not going to be an issue. She was eating a varied diet providing enough calories to adequately fuel her body. And her weight continued to be maintained in a healthy range for her height. So it was easy to reassure Mrs. Katz.

Just because some vegetarians may be restrictive eaters, that’s not to say that you can’t be a healthy vegetarian and successfully meet your nutritional needs.

If you’re motivated to be a healthy vegetarian consider the following:
  •     A balanced vegetarian diet requires planning. Actually, you can say the same thing for balanced eating of any type. But it is easier to throw a steak on the grill than to cook rice and dry beans.
  •     Take advantage of vegetarian resources. Explore the many vegetarian cookbooks and websites for easy, delicious recipes. (Check out some of my favorites on this blog—lentil stew, lentil soup, vegetarian chili and corn bread, granola to name a few. As for cookbooks, my old favorites are Mollie Katzen’s updated Moosewood and The Enchanted Broccoli Forest, as well as the Vegetarian Epicure by Anna Thomas.
  •     Eating out? Consider Indian resturants, and other Asian cuisines (offering tofu based vegetable filled dishes), which typically offer a large selection of vegetarian options.
  •     Cook soups, stews, and casseroles and freeze them in small batches to provide quick and convenient vegetarian meals.

Being vegetarian clearly has its merits. It makes us more mindful of where our food comes from and its impact on the environment. (For true enlightenment, check out the movie Food, Inc. with Michael Pollan or his books including The Omnivore’s Dilemma). But choosing vegetarianism means not just being morally responsible. It requires being responsible for meeting your body’s needs. And that is equally important.

Do you have a favorite vegetarian cookbook or website? Have a thought to share on this post as a vegetarian or a soon-to-be vegetarian? Please share! I’d love to hear from you.


  1. I realized within a few months of trying out vegetarianism that it was simply not for me. I like meat--not in huge quantities, but something would be lacking in my life if I completely took meat off the table.

    I also realized a few years ago that sometimes you need meat. I had a fairly routine operation that went wrong and ended up more handicapped than I had been before the operation. After spending a month in hospital/rehab, the first thing I craved when I got home was a good steak. My body needed it and I respected that. (P.S. revision surgery corrected the problem)

    This being said, I'm sure you can be a healthy, happy vegetarian, but it really does take extra work.

    I have a friend who is vegan. He doesn't eat meat for ethical reasons but has now also eliminated dairy because he says he has developed an "allergy" to it.

    All I can say is that his diet of pasta (white) and tomato sauce doesn't do anything for his muscle tone or his skin.

  2. I have more than a few friends that fall into this unhealthy vegetarian category. I'm a recent 'flexitarian' myself (no beef, pork, lamb or veal, but I still eat eggs, dairy, fish and some poultry). Due to a recent diagnosis of EE, with a primary symptom of dysphagia, I found myself eating liquids and pureed foods. And meat simply doesn't puree well. I always thought I couldn't give up red meat (specifically bacon), but when it had been a month without it, I realized I no longer had any craving for it. That, compounded with reading about the conditions in which livestock are kept and killed, made it a fairly easy choice. I feel better without it in my body, mentally and physically.

    Do I miss bacon? Sometimes. Can I live without it? Absolutely.

    I think that the key to health, at least for me, is to arm yourself with as much knowledge as possible. Good knowledge, from reputable sources. Not from advertisments put out by companies and councils who's primary goal is to sell you their product. Not from extremists, who's goal is to show you their truth and bring you to their side. Just solid facts about what specific foods do for your body.

    Great post, Lori! Keep 'em coming!

  3. Kurma Dasa 'Great Vegetarian Dishes' - best vegetarian cookbook ever! (yummiest felafel!!)

  4. I think if a person eats only processed food, no veggies, they're going to be malnourished, veg*n, carnivore, whatever. I think vegetarians can be completely healthy, as for vegans I'm not so sure. I was vegetarian for years, but my gym habit no longer tolerates that, though I still don't like meat too much. I'm not convinced that a person who eats meat/potatoes for most meals is healthier than a moderately conscientious vegetarian. Personally, I think veggie/whole grain/bean eating vegan + fish is likely the healthiest, but I'm not willing to give up cheese nor bacon, so there I don't go.

  5. Thanks for all the great comments! Yes, the message of this post fits the philosophy of this blog--there is no absolute good or bad way of eating. You could be an unhealthy vegetarian or a healthy carnivore, if you achieve balance in your eating. But it helps to be aware that just because a style of eating is associated with all things positive, it isn't necessarily so!

  6. I am in the life-long journey of recovery myself and I'm also a vegetarian. I believe that many people go into it under the guise of "healthy" when in actuality they are using those specific food choices for justification of an accepted form of restriction. This will sound hypocritical and snobby of me, but I do think that those who are vegan and shun anything--even natural things like eggs and honey--have disordered eating behaviors that merit a bit of concern.

    But for me, I never liked the taste of meat, so giving it up was never a challenge. While I do have some moral issues with the consumption of meat, I would make ethical choices if I decided that I wanted to add it back it--if I really wanted it. (However, I don't and don't think I ever will.) Make no mistake when I say that I know a majority of my food choices are still made by my head and not my body, but I don't think that the vegetarian aspect of it has anything to do with it.

    It's also a generalization that we fear fats--I love them and eat more food in a day than most "normal" people. But given my OCD and propensity for overexercise and "too healthy" choices, I've remained underweight. Great post!

  7. Thanks for your honest perspective, Abby. For clarification, certainly not all vegetarians fear fats. But fat restriction is not uncommon, and combined with vegetarianism, makes nutritional adequacy an issue. Thanks for reading!

  8. My sister has been a whole foods vegan for many years and has never suffered nutritionally for it. She eats nothing processed at all. Her protein sources include hemp, fermented soy, all manner of legumes, and nuts (nuts and nut butters are consumed daily). She also eats sea vegetables and sprouted grains regularly. Her diet is incredibly varied for a vegan, and she has never had any trouble meeting her calorie and nutritional needs. She doesn’t restrict her eating at all, and she doesn’t believe in low-fat anything. She eats this way not only for environmental and ethical reasons, but because it makes her feel highly energized and full of life. She is the healthiest person I know. With some forethought and planning, eating this way can also be cheap. My sister lives this lifestyle on the very limited budget of a graduate student.

  9. If only this were true for most vegans and vegetarians!

  10. Abby: Being vegan has nothing to do with shunning "natural" choices. It has to do with not approving of cruelty to animals, in ANY form, whether it be in slaughtering them, keeping cows constantly either pregnant or living with their babies torn from them so milk factories get 100% of their babies' food, or taking all the honey from bees' nests and replacing it with HFCS so they don't get all the nutrients they would naturally get from honey (which I'm sure makes less than hardy bees).

    I wish I could be a full vegan myself, but as someone recovering from an eating disorder, the restrictions of veganism are simply too triggering for me. So I make do with my ovo-lacto vegetarianism, with some vegan traits thrown in when I can (like buying soy milk instead of cow's, buying the Becel vegan margarine, etc). On the other hand, I'm trying to include more eggs and such, as I am actually anemic (which WAS caused by diet, but probably by my restricting several months back, and not by my vegetarian eating habits). But I do what I can.

  11. I tried to be a vegetarian but honestly can't do it. I think it is easier to eat a well balanced healthy meal than go all out vegetarian.

  12. It is on our own will if we feel to be a vegetarian. But if we can't do it, we should not force our self. Eating meat is not wrong, but we must not consume too much of it, vegetable and fruits are still better.